NSMD 2023: National Safe Motherhood Day is observed every year in India on April 11 to raise awareness about the care and treatment required for new or soon-to-be mothers. Since postpartum haemorrhage is one of the major factors responsible for 25% of all maternal deaths. It is responsible for 25% of all maternal deaths. In India, PPH incidence in India is 2%-4% following vaginal delivery and 6% following cesarean section, awareness around planning and having a safe route to motherhood is essential.
Something common between a new mother and an expectant mother is the safety of the baby and so we are going to discuss the very common cause of complications during pregnancy or delivery- The nuchal chord.
The uterine connection between a woman and her unborn child is made up of an umbilical cord, which resembles a tube. It is crucial in transferring nutrients and oxygen from the mother to the foetus. Yet, a nuchal cord is a condition that occurs when this chord wraps around a baby's neck for a number of reasons, including a longer umbilical cord or the baby's movement.
Nuchal cords are commonly seen throughout pregnancy, with incidence recorded at around 12% at 24 to 26 weeks and 37% at full term, according to research in the National Library of Medicine.
There are various reasons why this can happen, including excess fetal movement, a long umbilical cord, or a lack of amniotic fluid, said Dr Rashmi Baliyan, Gynaecologist and Obstetrician Consultant, Primus Super Speciality Hospital, New Delhi. "Additionally, factors such as advanced maternal age or certain medical conditions may increase the likelihood of a nuchal cord occurring," she told Zee English while describing that there is no one specific reason why the cord gets wrapped around the neck and that it is important for healthcare providers to monitor the baby's condition during delivery to ensure safe delivery.
While there is no specific body movement or exercise that has been linked to causing nuchal chords, there are some factors that may increase the risk. "Excessive fetal movement or a long umbilical cord may increase the likelihood of a nuchal cord occurring. Additionally, certain medical conditions or advanced maternal age may also play a role," explains Dr Rashmi while adding that sleeping position has not been directly linked to causing nuchal chords, but pregnant women are generally advised to avoid lying on their backs during the later stages of pregnancy to reduce the risk of complications.
Unfortunately, there is no surefire way to prevent a nuchal cord from occurring, as it is often due to factors beyond anyone's control, such as fetal movements or cord length. However, receiving regular prenatal care and monitoring the baby's growth and movements can help detect any potential issues early on.
"During delivery, healthcare providers may also monitor the baby's heart rate and may take steps to gently manoeuvre the cord if necessary. Overall, early detection and prompt management can help reduce the risk of complications associated with a nuchal cord," concluded Dr Rashmi Baliyan.
Dr Akta Bajaj, Senior Consultant and Head-Obstetrics Gynaecology, Ujala Cygnus Group of Hospitals explains that issues like a nuchal cord have no physical symptoms and it is usually only found during a routine ultrasound scan. Usually, no treatments or additional testing are recommended, unless the doctor feels there is a reason to be concerned.
"Infants with a tight nuchal cord may develop signs and symptoms such as hypotension, hypovolemia, decreased perfusion, and mild respiratory distress. Other findings occasionally noted may include facial duskiness, facial petechiae, subconjunctival haemorrhage, facial suffusion, or skin abrasion around the neck due to tight nuchal cords," she remarks.
Some common issues during pregnancy may include fetal nuchal translucency, preeclampsia, preterm labour, gestational diabetes, depression, and anxiety. In the case of fetal nuchal translucency, fluid collecting behind the neck can be detected by ultrasound scanning, and it can be measured. The more fluid that has accumulated, the greater the risk of an abnormality being present," Dr Akta summarises the discussion and advice new mothers to stay connected to their healthcare provider and report any issue that may cause stress to them or the baby.
People focus on mothers’ health more during the pregnancy and usually tend to ignore their postpartum health. But health problems, some life-threatening, can happen in the weeks and months afterwards and many aren't aware of the warning signs.
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